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Interview with Louis Burns, CEO, Care Innovations

Louis Burns is CEO of Care Innovations, the joint venture between Intel and GE that’s aiming to change the world of home care and patient to clinician connectivity. Clearly there’s been lots of money and effort invested — but what are they doing and where are they going? And what new products and services can we expect (beyond the ones Eric Dishman told me about last Fall)?

Last week I got to speak to Louis to figure out at least some of the answers to those questions. Not the least of which is, why did these two giants decided to team up?

Here’s the interview

Near Chicago next week? Meet Todd Park!

If you’re near or in Chicago next Weds (April 27) and you care about health data, applications or innovation, we highly recommend that you get to a Community Forum on the Health Data Initiative. The formal invite & details follow–Matthew Holt

James M. Galloway, MD, Acting HHS Regional Director and Regional Health Administrator, Region V invites you to a community dialogue hosted in Chicago on the Health Data Initiative with Todd Park, HHS Chief Technology Officer.  Todd Park joined HHS as Chief Technology Officer in August 2009. In this role, he is responsible for helping HHS leadership harness the power of data, technology, and innovation to improve the health and welfare of the nation.

One of his priority projects, on behalf of Secretary Sebelius, is the Community Health Data Initiative.  The Community Health Data Initiative is a public-private collaboration among federal, state, local and private organizations, that aims to make indicators of health available to a broad array of users.  Health indicators represent data from populations or groups of individuals that can be used to reflect health trends or differences in health status, cost, quality, and health system performance.

This is an opportunity for public health officials, businesses, academic institutions, providers, hospitals, health plans, and advocates to learn more about the Community Health Data Initiative, in particular, on the use of health and health care data to improve performance.  More information on the initiative can be found at http://www.hhs.gov/open/datasets/communityhealthdata.html.

We hope that you can join us in a community dialogue with Todd Park!

When: Wednesday, April 27th from 2 – 4 p.m.

Where: The MidAmerica Club (inside the Aon Building)
200 E. Randolph, 80th Floor
Chicago, IL 60601

Why: You can help improve the health of our nation and the reach of this program in our community.

RSVP: Space is limited. Please RSVP for this free event by Friday, April 22nd to Ms. April Dublin at april.dublin@hhs.gov or 312-353-1385

Video Collage: KP Center for Total Health

This week I spent quite a bit of time at the very new and very fancy Kaiser Permanente Center for Total Health in Washington DC. It’s next door to a very large medical office building  (110+ docs) in which KP is showcasing its current integrated care model, and how far its come in its mid-Atlantic region. The Center is  a pretty fascinating place–part tech and idea showcase and part meeting room. Certainly no other health care organization that I’m aware of has spent so much on a place designed to stimulate the imagination and enhance conversation–under the nose of the folks on Capitol Hill. I won’t get into here whether this is how money should be spent in health care but on balance I’m a  fan. (FD KP is a sponsor of the Health 2.0 Conference I co-run).  Instead I want to try to give you a feel for the place, and why it fits their vision and what it’s trying to demonstrate.

I took a tour with some colleague journo/blogger types led by the always expressive Robbie Pearl (CEO of the Permanente Groups in N Cal and now DC too–the airlines thank him!) and with Phil Fasano, CIO of the whole organization. Robbie is not shy in voicing his opinions (as you’ll see) and Phil occasionally trots out the voice of caution to reel in Robbie’s vision a tad. It was great fun.

What was also fun was the cocktail party at the grand opening. There I met three of my favorite DC-based ladies in health: Deven McGraw, Regina Holliday & Cindy Throop. So we’ll start with that fun video, and then there’s a whole lot more from the tour of the center after the jump. All these videos are pretty short.

After that fun and games, lets head to the tour. This is a series of videos of me and a few others testing out the displays, and listening to Pearl &  Fasano, as well as asking them a couple of pointed questions.

But I’ll take the tour in order….after a quick thanks to Holly Potter, Danielle Cass, Ravi Poorsina & center boss Julie Norris who with a ton of their colleagues worked their butts off keeping hundreds of visitors informed and entertained.

First up, Robbie Pearl on the current state of the KP.org health record and why we shouldn’t have to put up with less; what he called the 19th century state of medicine. And I can assure that is on display in my wife’s OBGYN office every time I visit.Continue reading…

Inspiration, spirit, connection, optimism–Health 2.0 Spring Fling

It’s been crazy post Health 2.0 Spring Fling in San Diego, I tried do my wrap of highlights and feelings from this Health 2.0 before the plane touched down last week, but I never quite finished them. So with a little hindsight, here are some snippets of my experience. Now this was just one experience–Indu and I will write a more detailed statement about what’s next for Health 2.0 soon–but clearly the feeling at this intimate and deeply personal Health 2.0 was more about feelings, spirit and emotion than it was about technology.

Karen Herzog has been virtually at every Health 2.0 and she said right at the end that several companies are teaching wisdom and mindfulness and that we need to merge Wisdom 2.0 (yes that’s a conference too) with Health 2.0. My flip response was that I’d been working in the health care system twenty years and had yet to see any wisdom in it. Not true of course, but as Arnie Milstein pointed out, we have a system that continues to diverge the trend lines between health care cost growth and GDP growth. And at some point that “shark” jaws will bite us.

What really struck me and struck Karen too, was that one of the keys Arnie discovered for communities with high performing but lower cost health care systems (in the US) was that the patients there really felt that the medical team cared about them. He asked the audience how many people felt the same about their care providers–and from around 300 people fewer than five hands went up.

Flipping the whole conference around, we started with a period of intensely personal fireside chats. America’s pediatrician, Alan Greene, talking about the one moment that can change the obesity epidemic–the Whiteout movement’s pledge to make each baby’s first bite of food be real food, not white rice baby cereal. Kolya Kirienko told an incredible story of recording his own patient narrative saved his life several times, and how he is now (funded by Robert Wood Johnson Foundation’s Project Health Design) building a narrative-capturing system that will really help patients record observations of daily living.

Finally an amazing troika of JD Kleinke (read his new novel Catching Babies), Amy Romano (@midwifeamy) and Health 2.0’s own mum to be Indu Subaiya dived into the amazing microcosm of our health system that is obstetrics. JD told Amy: childbirth is the one place where the patient has a choice to really opt out. You can’t have your hip replaced at home in a tub by someone the medical profession abhors. But you can have your baby “caught” that way. And Indu discussed how she as an MD made the decision to move from the trad OBGYN to a midwife and birthing center.

And not a demo in sight.Continue reading…

Emotional Automation Revisited

Last week we all watched in awe as the IBM computer, Watson, trounced two of Jeopardy’s finest.  This event has been much heralded but it is worth stopping for just a minute to reflect on the experience of watching Jeopardy those three nights.  I had no trouble rooting for Watson, feeling disappointed or embarrassed when he missed a question and chuckling when he displayed any behavior that seemed the least bit human.  I knew the whole time, on one level, that Watson is a computer.  On another level though, I bonded with him and felt a good deal of emotion regarding his success.

MIT Prof. Sherry Turkle recently released a book entitled Alone Together.  She was also interviewed recently on TechCrunch.  Turkle puts forth the view that technology is a poor substitute for interaction with a human being. However, she notes that when technologies (robots, relational agents and the like) respond to us, they push “Darwinian buttons,” prompting us to create a mental construct that we are interacting with a sentient being.  This brings a host of emotions to the communication including affection.  Turkle makes an argument that in the realm of human relationships this phenomenon is unhealthy for our species.

I’d like to bring in principles from behavioral psychologist, Robert Cialdini, who has authored several books on the psychology of persuasion.  Cialdini offers simple tools that can be used in everyday life to persuade others to adopt one’s point of view.  In doing so, he lays out solid experimental evidence that these tools are effective, in most cases without the recipient being aware.  Continue reading…

2011 Predictions: MU Goes Tactical, ACO Strategic

In the Healthcare IT (HIT) market, 2010 was the year of meaningful use (MU). Healthcare organizations (HCOs) of all sizes developed plans, began making IT modifications and began adopting the technology they needed to meet Stage One MU requirements and subsequently receive incentive payments, some of which began being disbursed in late 2010. As we move into 2011, we will continue to see an extreme amount of activity and turmoil in the HIT market with the biggest elephant in the room being what will actually happen to the healthcare reform bill that was passed at the beginning of 2010.

Against this backdrop, we once again have prepared our annual top ten (actually we have 11 for after all it is 2011) predictions for 2011 which are as follows:

1) MU Initiatives Move to Tactical. Meaningful use is no longer of great concern to the executive suite, well except for maybe the CIO and his counterpart, CMIO. It has moved to the tactical implementation stage for enterprises insuring that systems are in place, clinicians trained and MU requirements met to reap incentive payments.

2) C-Suite Strategy Focuses on New Payment Models. Despite the turmoil swirling around healthcare reform, one thing that is unlikely to change is the move to bundled payment models and the migration to Accountable Care Organizations (ACOs). The train has already left the station on this one and this train does not have reverse. The repercussions of these new payment models have the potential to make or break a HCO and the C-suite knows this thus are focusing all of their attention on what is the most appropriate strategy for their organization. Strategy service firms such as CSC, Dell, Deloitte, PWC, etc. are going to make out like bandits.

Continue reading…

Physician Executives Should Not Ignore How Smartphones Will Transform Healthcare

Physician executives who ignore smartphones and their healthcare applications will miss the most important disruptive technology trend in the next five years. Physician executives who understand how smartphones will transform the industry for providers, payers, patients, and employers will thrive in their careers.

Rajeev Kapoor, a former executive at Verizon, describes the smartphone-enabled transformation: “The paradigm of healthcare has changed. You used to bring the patient to the doctor. Now you take the doctor, hospital, and entire healthcare ecosystem to the patient.” (http://ow.ly/3GIir) Susannah Fox of the Pew Research Center’s Internet and American Life Project offers a specific example when she talks about the celiac disease patient who uses her smartphone to evaluate food products in the grocery store.

“You cannot call your gastroenterologist every time you buy a new product.” (http://e-patients.net/index.php?s=fox) David Jacobson of Wellpoint notes that “The technology of telehealth is well ahead of the socialization of the telehealth idea and we are at a tipping point for utilization to begin taking off.” (http://ow.ly/3GIir)

The Global mHealth Developer Survey found that today 78% of respondents said that smartphones offer “the best business opportunities for mobile healthcare” in 2011; by 2015, 82% said smartphones would dominate the industry. Cell phones, tablets, and PDAs trailed smartphones in popularity according to the survey. (http://ow.ly/1aVf9V)

Continue reading…

Advances in Connected Health Sensor Technologies

Most of the time I write about the psychology of patient, consumer or provider adoption.  This is not an accident.  The psychology of adoption is the next big hurdle for connected health to overcome.  We have good evidence that connected health solutions can be engaging and sticky for patients, leading to improved self-care. Likewise, we have evidence that enriching data coming from patients to providers can lead to better care decisions and that these decisions, made and delivered in the moment of need, are the other half of the magic of connected health. Further we have a sense that those patients who are not interested in the level of engagement that connected health demands often have worse outcomes and therefore cost the system more.

But today, I want to talk about technology.  Most of the time, I write from the perspective of a technology vision that includes continuous (or near continuous) sensing of multiple physiologic signals. These signals are flawlessly transmitted to a computing environment where decision support can be applied to aid in improved communication with patients and improved decision making by providers. The state of the art today is not so elegant.

We use multiple different sensors, both wired and wireless, communicating via a large variety of aggregator devices that then transmit the sensor outputs to us via the Internet.  The environment is both user-unfriendly and error prone, which increases the technical support resources required.   We have the strong sense that some individuals drop out of programs because the technology is too challenging for them, so we miss them before we can turn them on to the benefits of a connected health experience.

The marketplace for sensors is changing in a number of exciting, dynamic ways.  First, a number of sensors are coming to market that have embedded mobile chips right in them.  They are sold in the same way as the Amazon Kindle (the wireless connectivity is bundled in the price of the device).

Continue reading…

Obtaining Meaningful Use Stimulus Payments

Many clinicians and hospitals have asked me about the exact steps to obtain stimulus payments.

On January 3, 2011, CMS began registering clinicians for participation in meaningful use programs.    Every region of the United States has Regional Extension Centers which can help answer any questions. Here’s an overview of the steps you need to take.

1.  Choose between Medicare and Medicaid programs.  If you qualify, Medicaid offers greater incentives and does not require you to achieve meaningful use before stimulus payments begin.
a.  To qualify for Medicaid, 30% of your patient encounters must be Medicaid patients. (20% for pediatricians)
b.  To qualify for Medicare, keep in mind that meaningful use payments are made at 75% of Medicare allowable charges for covered professional services in the calendar year of payment, per the payment maximums below:

Year 1  $18,000
Year 2  $12,000
Year 3  $8000
Year 4  $4000
Year 5  $2000

Thus, a total of $44,000 is available at maximum, but could be less if your allowable Medicare charges are less than

Year 1 $24,000
Year 2 $16,000
Year 3 $10,667
Year 4 $5333
Year 5 $2667

Continue reading…

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